Individual
MRS. CHERYL ANDERSON-LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5901 N 71ST ST, MILWAUKEE, WI 53218-1821
(414) 461-2018
Mailing address
5901 N 71ST ST, MILWAUKEE, WI 53218-1821
(414) 461-2018
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303125031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35057800
—
WI
Enumeration date
05/24/2008
Last updated
05/24/2008
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